CARMA Résumé de rapport

Documentation of services for reintegration of the aged in Northern Ireland

The document begins with information on the Carma Project as part of the 5th Framework Programme of the European Commission, it details the partners involved and describes the project and methodology, which will be used.

The context is then described with information provided in general terms on the structure of the United Kingdom, which includes basic demographic details. The context is further developed with information provided on Northern Ireland detailing its Government, demographics and ethnicity.

As research shows financial problems are a major contributing factor in the marginalisation of older people a section is devoted to the financial situation of older people in the United Kingdom. This includes a summary of allowances provided by the state, details of allowances available for carers and information on company pensions, which are provided by employers.

Ill health and caring for people with ill health are also major causes of marginalisation in older people consequently information is provided on the National Health Service in England, Scotland and Wales, and the Health and Personal Social Services system in Northern Ireland. The structure of health and social service management and delivery is explained including information on the Department of Health, Social Services and Public Safety, the Social Services Inspectorate, Health and Social Services boards, and Health and Social Services Trusts.

It is well known and well documented by researchers, including work undertaken within the Carma project that older people prefer to remain living in their own local community. It is therefore appropriate the document moves on to consider community health and social services in Northern Ireland. The elderly programme of care had a total cost of £356 million in 1999/2000 within N. Ireland, and a table is provided breaking down the expenditure by activity.

Recognition is given to the care provided in the community by family friends and neighbours and a number of principles are outlined:- Care should be provided to people in a way that supports their independence and respects their dignity,- Services should meet each individual¿s specific needs pulling together social services, health, housing, education or any other service needed, access to services should be fair, open and consistent,- Every person should be protected against abuse, neglect or poor treatment while receiving care,- People receiving care should have an assurance that the staff they deal with are sufficiently trained and skilled,- People should have confidence in their local social services knowing that they work to clear and acceptable standards.

A list and description of the principle services used by older people follows. The majority of services are free to the service user. This includes hospital services and all community health and personal social services. Residential and nursing homes are means tested and currently 15% of these service users pay either full costs or an assessed contribution. The services commonly used by older people are: The Doctor (General Practitioner), the Pharmacist, Community Nursing Service, Community Mental Health Services, Allied Health Professionals which includes the Physiotherapy, Occupational Therapy, Podiatry, Speech and Language Therapy and Dietetics. The list also includes Community Care Assessment, Social Work Services, Home Care Services, Residential and Nursing Home Care, Housing Adaptations and Aids, Sheltered Dwellings, Supported Housing, Day Care Services, Meals on Wheels, Sensory Impairment Services, Care and Protection Teams for older people, Hospital Discharge Planning Teams, Transport Services and Intermediate Care Services.

The final section of the document is titled ¿Strategy development for the future¿ and highlights a number of new services aimed at reducing marginalisation by providing services responsive to the needs of older people in new ways. These include the Rapid Response Service of South and East Belfast Trust, a One Stop Assessment Centre at the Ulster Community and Hospitals Trust, an A & E Diversion Scheme at Home First Community Trust and a Hospital at Home Scheme with Down Lisburn Trust.

In the conclusion of the document one issue raised was the administration of health and social care and the number of public bodies involved. In November 2005 as part of the Review of Public Administration in Northern Ireland The Health Minister has announced the four health & social services boards will become one regional authority and 18 health and social services trusts will become five.